Hard Times and Mental Illness
There is a positive relationship between extreme financial and social difficulties and the onset of mental illness. This relationship is through the pathway of increased Stress, which is common at such as Nigeria is currently undergoing. Relationship is not necessarily a ‘direct, causal’ one – in the sense that economic difficulties are directly leading to an increased incidence of mental illness. Rather, when there is increased Stress on the citizens, there is the likelihood that more individuals will reach their ‘threshold’ for various illnesses that they may be innately genetically or constitutionally susceptible to (including even physical illness such as hypertension) but which they might not have succumbed to in the absence of such a ‘precipitant’.
The evidence (statistics) to back up these claims:
Unfortunately there are no clear statistics showing an increased trend in the prevalence of mental illness. However, there are plenty of anecdotal – often sensational stories, especially pertaining to Suicide, e.g. the recent sad story of a banker in Lekki. A properly confirmed upward trend in Suicide could act as a ‘litmus test’ of increased mental illness in a society, since there is a clear link between Suicide and Depression (as well as a number of other mental health conditions).
How common is Mental Illness?
Mental illness (like ‘physical illness’) exists in a large number of varieties, each with different characteristics, different treatment modalities, and different implications for the individual, now and in the future. The life-time prevalence of Mental Illness (i.e. the number, out of a hundred citizens, that would be expected to have at least one episode of mental illness in their lifetimes) is variously quoted from 7%-15% in Nigeria.
Is there a connection between our difficult economic conditions and a rise in Suicides?
Most of the evidence locally is anecdotal, and comes from sensational stories about students, professionals and even rural dwellers being reported in the press. The assumption of an upward trend in the rate of ‘successful’ suicides’ is a reasonable one to make, but it needs to be backed up by properly conducted research.
One million people die annually all over the world from suicide. WHO statistics (2012) ranks Nigeria 102 among the list of nations in the incidence of suicide among the population, with an annual figure of 6.5 for every 100,000 in the population, and a strong male preponderance. Obviously a lot of work needs to be done to deal with that, as well as heading off any putative upward trend.
Solutions
Government: Government must do everything possible to create a conducive economic and general living environment for the citizens, including attending to the needs for creation of a sense of ‘community’ in every living area, provision of amenities, and a cushioning of the worst ravages of economic adversity through some form of Social Security. In addition, the operation of a compulsory, all-embracing Health Insurance system that automatically takes care of all citizens, including the vulnerables and unemployed is of absolute essence in coming to grips with the needs of the people.
Family: The family unit must pursue cohesion. Mutually supportive cohesive family structures are the strongest insurance against severe Stress, which may precipitate mental illness.
Individual: Citizens need to embrace supportive family and other relationships. The most vulnerable people to the ravages of Stress are those who are socially isolated. Positive involvement with other people, such as voluntary work or philanthropy is a strong factor in creating emotional well-being in the individual. Regular exercise and Relaxation are strong positive elements. Religious faith and moderate practice of positive tenets or Religion and Ethics help to enhance stability. Moderate social habits (including avoidance of excesses such as alcohol use and sexual promiscuity) is also a potential enhancer of individual stability.
Dr Femi Olugbile FRCPsych FNIM
